HT Health » nutritionhttp://health.heraldtribune.com
Just another Herald-Tribune Media Group siteTue, 03 Mar 2015 17:30:41 +0000en-UShourly1http://wordpress.org/?v=4.1.1The benefits of prebiotics in the diethttp://health.heraldtribune.com/2015/03/03/benefits-prebiotics-diet/
http://health.heraldtribune.com/2015/03/03/benefits-prebiotics-diet/#commentsTue, 03 Mar 2015 15:20:32 +0000http://health.wp.htcreative.com/?p=24289Read more »]]> Q: I know what probiotics are, but what are prebiotics?

A: By now you have heard that probiotics help us absorb nutrients from the foods we eat, and they produce B vitamins we can use; they support our immune system and work to prevent harmful bacteria from making us sick.

Chances are you have been actively inviting them in by eating yogurt and kefir, or some types of sauerkraut, kimchi and tempeh.

You may be also taking supplements.

But it’s not enough to just get beneficial bacteria into your body. To make sure these good guys thrive, you’ve got to feed them. One of their preferred meals is a soluble fiber called fructooligosaccharides (FOS), found in a wide range of vegetables, fruits and grains.

Because FOS helps probiotics thrive, this fiber and its relatives have been dubbed prebiotics. It’s a term we’ll be seeing more as scientists unravel the details of how our gut microbiome works.

Besides occurring naturally, prebiotic fiber has been isolated from chicory root to produce a food additive called inulin. Inulin is an ingredient in many light and low-fat yogurts because, along with supporting the live cultures, it acts as a fat replacer, providing a creamy texture and slight sweetness.

Manufacturers have been adding inulin to juices, bars, ice creams and cereals, to ratchet up the fiber content of those foods. Although it appears to be safe, and possibly beneficial, keep in mind that adding inulin doesn’t make that food healthful, and getting too much inulin (more than 10 grams a day) can cause gas and bloating.

It is best to focus on getting prebiotics from whole foods, such as bananas, asparagus, Jerusalem artichokes, barley, whole wheat, garlic and onions.

Eating a salad a day is a habit I adopted a while back to help me automate the eating of raw veggies. Either my lunch or my dinner usually is built around some sort of salad. And I try to stay true to the spirit of healthier eating when I do so.

Meaning fried chicken tenders propped on top of a bed of greens doesn’t quite cut it. Of course, salads are easy in summer. We celebrate sun-ripened tomatoes in a caprese salad, or happily pluck juicy strawberries from the field to toss with a bunch of peppery greens. But winter salad? I say enthusiastically: Yes!

One of my favorite winter salads that manages to feel both energizing and comforting at the same time is this chopped kale and lentil salad. The star is a handy box of steamed precooked lentils. Most grocers carry these alongside the packaged produce.

Keep a box in the refrigerator and you’ll find a million ways to use those lentils. Add a handful to soups, pasta or quinoa dishes, tuck some into an egg white omelet topped with salsa, or saute some up with brown rice and curry paste.

Looking to save a little cash? It’s easy to boil up your own lentils (dry lentils are cheaper). The easiest way to cook dry green lentils is to boil them in ample salted water until al dente, about 12 to 15 minutes.

Either way, lentils are a nutritional bargain. Each cup of lentils is packed with folate, 16 grams of fiber and 18 grams of protein.

Place the shallots in a small bowl, then pour the vinegar and boiling water over them. Add a pinch of salt, then stir and set aside to pickle for 5 minutes.

Meanwhile, in another small bowl prepare the dressing. Whisk together the mustard, lemon juice, vinegar and water. Drizzle in the olive and whisk until emulsified. Add pepper and black truffle salt, if using.

Once the shallots have pickled for 5 minutes, add the diced pear, toss for a few seconds, then drain, discarding the liquid. Use paper towels to blot the shallots and pear dry, then add them to the salad bowl. Pour the dressing over the salad, then toss to coat.

Drizzle on more olive oil if desired before serving. Six servings.

Nutrition per serving

■ 260 calories

■ 130 calories from fat (50 percent of total calories)

■ 15 g fat (1.5 g saturated; 0 g trans fats)

■ 0 mg cholesterol

■ 26 g carbohydrate

■ 9 g fiber

■ 6 g sugar

■ 10 g protein

■ 240 mg sodium

Food Network star Melissa d’Arabian — melissadarabian.net — is an expert on healthy eating on a budget. She is the author of the upcoming cookbook, “Supermarket Healthy.

]]>http://health.heraldtribune.com/2015/03/03/whenever-chills-arrive-salads-get-substantial/feed/0So-called ‘superfoods’ are not magic bullets against cancerhttp://health.heraldtribune.com/2015/03/03/24276/
http://health.heraldtribune.com/2015/03/03/24276/#commentsTue, 03 Mar 2015 13:30:49 +0000http://health.wp.htcreative.com/?p=24276Read more »]]>Blueberries. Green tea. Tomatoes. And, oh, that cruciferous cauliflower. All make the lists of superfoods that might help prevent cancer. Then there are the foods such as smoked meat and fried foods that supposedly might cause cancer.

Such information is standard fare for TV doctors and Web sites, but most of us don’t know how to judge such claims.

What sounds authoritative may not be. Only about half of the recommendations on two internationally syndicated TV medical talk shows were supported by scientific evidence, according to a recent study in the journal BMJ.

“The messages that the public is getting are bits and pieces, without the big picture,” said Walter Willett, chair of the Department of Nutrition at the Harvard School of Public Health. “It’s sort of the Wild West out there in terms of what people hear about nutrition and cancer.”

Of course, the blueberries we eat today are good for us. But nutrition’s role in cancer prevention is much more complex than a single dietary component: Evidence has mounted, for example, that lifestyle — diet, weight control and exercise — is vital in helping reduce risk.

For now, experts endorse general dietary advice that is healthful for a variety of chronic diseases and conditions, rather than reductionist thinking that focuses on single foods or nutrients.

Reductionist thinking neglects the broader approaches of cancer nutrition research, including eating patterns and the mechanisms of microbiology. The quest now is for answers about nutrition’s relationship to the many challenges of cancers — challenges that go beyond any individual study.

BE SKEPTICAL

When you hear that a certain food helps prevent cancer, ask: Which cancer?

“Cancer is multiple diseases,” said Marian Neuhouser, a nutritional epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle.

Whereas cardiovascular disease might be broken down into several types, including myocardial infarction, stroke and peripheral vascular disease, she said, “for cancer, it’s really over 100 different diseases.”

“Cancer is a very complex, very challenging disease to study, whether you’re looking at it on the cell level or the clinical level or the epidemiologic and preventive level,” Willett said.

Cancer occurs when abnormal cells divide uncontrollably. But one cannot assume that all cancers operate in the same way, said Geoffrey Kabat, a cancer epidemiologist at the Albert Einstein College of Medicine in New York. Different cancers can have somewhat different risk factors, which may or may not overlap: The cancers linked to tobacco, for example, might differ from those linked to radiation.

Researchers caution about overreacting to a single study. New findings come out every week, but “we never take any one study to be the answer to anything,” said Nancy Potischman, a nutritional epidemiologist at the National Cancer Institute. Only if the same results come up in multiple studies across multiple populations, “then you might think that, yes, this food might be important,” she said.

While it’s relatively easy to see the effect of a food on a lab animal, it’s difficult to study humans, who put variety on their plates.

Population studies query participants about what they eat and follow them through a time period. Clinical trials might have a group that eats a certain food or nutrient and a control group that doesn’t consume that food, but these studies are very expensive, specific and hard to organize and maintain.

Sometimes findings that are promising in early research don’t prove to be definitive in follow-up studies.

Still, we yen for simple strategies. For a while, attention focused on folic acid, which didn’t quite live up to all its hopes, at least for cancer. Now there’s a great deal of interest in vitamin D.

“There’s a process of making hypotheses and testing them,” said Jo L. Freudenheim, a professor of epidemiology and environmental health at the State University of New York at Buffalo. “To the extent this goes out to the public, it can lead to unreasonable expectations.”

And that can set off the next new fad.

HEALTHY HABITS

Tobacco use remains the leading preventable cause of cancer incidence and death worldwide. After tobacco, the lifestyle trio of diet, weight control and exercise may be linked to one-third to two-thirds of cancers.

“They’re inseparable,” Neuhouser said. “You can have a great diet and you can have a healthy weight, but if you’re extremely sedentary then there’s a risk.”

And there’s a strong link between excess weight and several kinds of cancer, including the esophagus, breast (after menopause), endometrium, colon and rectum, kidney, pancreas, thyroid, gallbladder, according to the NCI. Exercise helps balance calories consumed and calories burned.

Evidence mounts about how lifestyle may affect risk of cancer. In the largest study of its kind, nearly half a million Americans were evaluated for adherence to American Cancer Society cancer prevention guidelines that include smoking avoidance; a healthful, consistent weight; physical activity; limiting alcohol; and a diet emphasizing plants.

Those who followed the guidelines most closely had lowered risk of developing cancer (10 percent for men, 19 percent for women) and dying from cancer (25 percent for men, 24 percent for women) compared with those whose habits were least in line with the guidelines.

Most striking was the reduction of overall risk of dying: 26 percent for men, 33 percent for women during the 14-year study period.

Fourteen types of cancer seemed affected by lifestyle behavior, most particularly gallbladder, endometrial, liver and colorectal. For men and women, a healthful weight and physical activity were the top factors in reduced deaths overall. Albert Einstein College of Medicine Researchers published this analysis online in January in the American Journal of Clinical Nutrition, based on data from a National Institutes of Health/AARP study.

Kabat, the study’s lead author, said that these results, while encouraging, might be explained by unknown factors: Those who best follow guidelines might be particularly health-conscious and have good access to health care. But overall, the findings affirm decades of other studies showing that “maintaining a healthy weight, physical activity and maybe certain aspects of diet are associated with better health,” he said.

Another approach to cancer and nutrition considers dietary patterns. “What we eat on any one day is not going to change our cancer risk, but it’s the pattern over the long term.” Neuhouser said. Several diets that emphasized fruit, vegetables, whole grains and plants or plant-based proteins were analyzed against information collected over more than 12 years from nearly 64,000 post-menopausal women in the Women’s Health Initiative Observational Study. Consuming a high-quality diet was associated with lower death rates from chronic diseases including cancer, as reported last year in the American Journal of Epidemiology.

WHAT WE EAT, WHEN

For researchers in the field of developmental nutrition, the quest is not what you eat, but when you eat it.

“We don’t fully understand whether or not there are certain periods of life which are more important to have healthy aspects of the three pillars” of diet, exercise and weight, Neuhouser said.

For breast cancer, for example, researchers are looking at nutrition at birth and time of first period through first pregnancy, Freudenheim said. Evidence is increasing that eating red meat in high school might have a bearing on the development of some kinds of breast cancer decades later, Willett said.

Also, alcohol consumption by young women may raise the risk of breast cancer later in life. Greater understanding of metabolism might offer clues to how cancer cells develop, according to the National Cancer Institute’s Potischman. Metabolomics is an emerging branch of science that focuses on metabolites, the substances produced through digestion and other bodily processes.

The bacteria, viruses and other organisms that live in and on humans seem to play a bigger role in health and disease than was previously understood, Freudenheim said. How the countless microbes in such areas as the gut and the mouth might contribute to or prevent cancers is one of the open questions in the new area of study of the microbiome, which refers to the many organisms in the body, 10 percent of which are human and 90 percent nonhuman.

Nutrigenetics considers what we eat, the components in our foods and their interactions with genetic processes.

Regarding diet, “right now we’re making blanket recommendations, but one size doesn’t fit all,” says Stephen Hursting, a professor of nutrition at the University of North Carolina at Chapel Hill. He said that someday research on our genetic and biochemical differences might lead to personalized dietary recommendations to reduce cancer risk.

]]>http://health.heraldtribune.com/2015/03/03/24276/feed/0Psyllium allergy is rare, but possiblehttp://health.heraldtribune.com/2015/03/02/psyllium-allergy-rare-possible/
http://health.heraldtribune.com/2015/03/02/psyllium-allergy-rare-possible/#commentsMon, 02 Mar 2015 10:00:56 +0000http://health.wp.htcreative.com/?p=24094Read more »]]>DEAR DR. ROACH:I would like to know if you have ever heard of a person being allergic to psyllium fiber? My doctor suggested I take Metamucil for constipation, as opposed to stool softeners. However, when I took it, my face and eyes began to itch, I began to wheeze and I coughed until I vomited it up. My doctor stated he had never heard of anyone being allergic to it. As a side note, my husband has used Metamucil for years, and I have had a couple of episodes of wheezing and shortness of breath that could be attributed to inhaling some of the powder when he mixed it. -- P.G.

ANSWER: I haven't seen any cases either, but it can happen, rarely -- most often to people who have allergies to grasses or dust. It is possible that inhaling some of the powder started the allergy. I would be careful to stay away from the area where your husband is mixing his, as allergies sometimes worsen over time.

Unfortunately, you will have to find another source for fiber. Good dietary sources include wheat bran, prunes and prune juice. If you need a supplement, you may try methylcellulose (such as Citrucel), wheat dextrin (like Benefiber), and calcium polycarbophil (Fibercon). Be sure to get enough fluid, and start with a low dose and then slowly increase.

The booklet on constipation explains this common disorder and its treatments. Readers can order a copy by writing: Dr. Roach -- No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$5 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. ROACH:In January, you published information regarding the shingles vaccine in someone with genital herpes who is being treated with acyclovir. You forgot to say that the person must stop the acyclovir for a period of time before and after the vaccine is administered. -- C.L.B.

ANSWER: The Centers for Disease Control and Prevention has recommended that, if possible, antiviral agents such as acyclovir, valacyclovir and famciclovir should be discontinued for at least 24 hours prior to administration of zoster vaccine, and not used for at least 14 days after vaccination. Although there is no data to prove the vaccine does not work, in theory the antiviral agents may interfere with replication of the weakened vaccine strain of varicella-zoster virus contained in the vaccine.

DEAR DR. ROACH: In your recent column on glaucoma, you neglected to mention that doctors of optometry treat glaucoma, as do ophthalmologists.

You should be aware that approximately 70 percent of the eye exams done in America are done by doctors of optometry. Optometrists are the first line of defense against ocular problems such as glaucoma.

Additionally, doctors of optometry are in virtually every county in America, as opposed to ophthalmologists, who tend to be located primarily in urban areas -- hence, optometrists are frequently the first and only eye doctor seen by rural Americans.

We hope that in the future you will point out this fact to your readers, so they may avail themselves of timely, effective care of their ocular conditions. Sincerely, Dr. James D. Sandefur, executive director, Optometry Association of Louisiana

ANSWER: I did not know that. I confirmed that optometrists may prescribe treatments for glaucoma, except in Massachusetts. I appreciate your writing.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/03/02/psyllium-allergy-rare-possible/feed/0Implanted back pain pump is option for very fewhttp://health.heraldtribune.com/2015/02/26/implanted-back-pain-pump-option/
http://health.heraldtribune.com/2015/02/26/implanted-back-pain-pump-option/#commentsThu, 26 Feb 2015 10:00:26 +0000http://health.wp.htcreative.com/?p=24027Read more »]]>DEAR DR. ROACH: I am a 79-year-old man in pretty good health who has had back problems for about 15 years. I have been to two pain clinics and four neurosurgeons in the past few years. All find that I have spinal stenosis in the lumbar region. I have had shots, physical therapy and electrical-stimulation treatments, and have tried several drugs: All with no help. The surgeons say that surgery is not going to help.

The last pain clinic sent me to a doctor who specializes in pain pumps. The doctor explained how the pump works, and (after checking X-rays and an MRI) says that he thinks the pump would help me. He also suggested that I check with my primary and other doctors for their input as well as going to the Internet for information.

My four different doctors all say they have no knowledge regarding pain pumps. Several sources on the Internet had only negative information. They explain what a pain pump is but give no information regarding percentages of success and failure. I would really like to try the pump, but the negative information on the Internet (dislodged pumps requiring corrective surgery, onset of migraine headaches, malfunctioning pumps, breaking leads from pump to spine), frankly, scares me.

Do you have factual information on the success rate with pain pumps to the lumbar region? -- D.M.

ANSWER: These are implantable, programmable devices that contain a pump and reservoir to be placed in the abdomen (which needs to be refilled regularly with medicine injected through the skin) and a plastic tube (catheter), which ends in the fluid around the spinal cord, called the intrathecal space. The pump is usually filled with morphine. The main reason that intrathecal pumps are used is to have high concentration of pain medication around the spinal cord, where there are many opioid receptors, without having high concentrations in the blood. In theory, there should be fewer side effects.

Your doctors didn't know about their effectiveness because there is very little published information. However, there was a review in 2007 that showed that 38 percent to 56 percent of users reported at least a 50 percent reduction in pain at six months.

You mentioned some of the complications of pumps. About 18 percent of people had at least one complication of the catheter, while 27 percent required reoperation due to equipment failure. There are many other possible complications from the medication itself, the most common being nausea and vomiting, in 33 percent.

As you can see, because of the relatively low effectiveness and relatively high complication rate, most people need to have severe symptoms before they consider these pumps.

DEAR DR. ROACH: In August I had open repair of my right rotator cuff. I was told it was a severe tear with bone and tendon involvement. I am 67, and the recovery has been a long one. If you can believe it, even with physical therapy and pain management, I am still uncomfortable at times. I have a stupid question that I hope you can answer. Ever since surgery, I have had to sleep on my unaffected side. Is it OK for me to finally try sleeping on my right side? I don't have another appointment at the orthopedic office. I am embarrassed, as it is one question I haven't asked. -- C.V.

ANSWER: It's not a stupid question at all. I don't think you will damage the surgery repair by sleeping on the shoulder now, and you certainly can try it to see if it feels uncomfortable. I also would recommend you continue the exercises your physical therapists gave you.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/02/26/implanted-back-pain-pump-option/feed/0Listen to your thirst to determine fluid needshttp://health.heraldtribune.com/2015/02/25/listen-thirst-determine-fluid-needs/
http://health.heraldtribune.com/2015/02/25/listen-thirst-determine-fluid-needs/#commentsWed, 25 Feb 2015 10:00:18 +0000http://health.wp.htcreative.com/?p=24025Read more »]]>DEAR DR. ROACH:We are always being told to drink water -- the consequence of which, of course, is increased urination. But what about the kidneys? Since they have to perform repeatedly, are they being worn out prematurely?

I am a 62-year-old female. On my past physical, I was told that my bladder had dropped a bit. Does this have anything to do with excessive urination caused by drinking too much water? -- R.R.

ANSWER: The kidney is capable of performing its two primary functions -- removing waste products and maintaining salt and water balance -- under a wide variety of conditions. In fact, a healthy set of kidneys can get rid of 40 liters of water daily. Even so, a high water load does cause the kidney to work hard, especially under the now-rare condition of minimal salt intake. Unfortunately, damaged kidneys sometimes cannot handle a high water load.

I often get frustrated with the recommendation to drink a certain quantity of water, most commonly 8 cups a day. That amount is too much for some people, and not enough for others. Listening to your body and drinking when you are thirsty is, in general, a much better approach. There are some instances where drinking more water than you feel you need makes sense: in people with a history of kidney stones, for example. Some older people have inadequate thirst mechanisms, so an extra glass or two of water might be a good idea for them, and won't cause problems in most people.

Your second question, about a "dropped" bladder, has nothing to do with the kidneys. Descent of the bladder -- a type of pelvic organ prolapse -- is caused by changes in the pelvic floor, especially in older women who've had multiple childbirths.

DEAR DR. ROACH: I am a 65-year-old woman and have been on valsartan, 160 milligrams, for hypertension for many years. My blood pressure has been under control with medication, in the 120-140/80-95 range most of the time. I had one episode each in 2013 and 2014 with spikes of 175/105 and 212/110, respectively. The emergency room where I ended up did tests and released me after four hours when no damage was found in my organs and my blood pressure came back to the 160/95 range. I would like to understand the reason for these spikes. My doctor said that the cause is stress. However, when discussing this with a co-worker, she suggested that I seek a second opinion, and said that multiple sclerosis or my gallbladder could be the issue here. What is your take on the potential causes of these spikes? Should I be asking for other diagnostic tests, and what might they be? -- D.C.

ANSWER: Spikes in blood pressure can be physiologic -- that is, a normal response to stress or other stimuli -- but your numbers are concerning. Erratic blood pressure in multiple sclerosis is not uncommon, but the pressures tend to go lower, not higher. I can't think of how gallbladder problems would cause high blood pressure in absence of pain. In any event, neither of these is a common cause of blood pressure spiking.

Periodic release of substances that raise blood pressure, especially in pheochromocytoma, classically cause a flushing sensation and BP spikes. Blockages of the arteries of the kidneys can as well. These are rare but serious, so it may be worth asking your doctor about them.

If your usual blood pressure can get as high as 140/95, it may be appropriate to add therapy. This may be a second medication, such as a diuretic, or nonpharmacological treatment.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/02/25/listen-thirst-determine-fluid-needs/feed/0Sitting a lot is harmful, even if you exercisehttp://health.heraldtribune.com/2015/02/24/sitting-lot-harmful-even-exercise/
http://health.heraldtribune.com/2015/02/24/sitting-lot-harmful-even-exercise/#commentsTue, 24 Feb 2015 15:49:00 +0000http://health.wp.htcreative.com/?p=24089Read more »]]>Q: I’ve read that sitting is bad for my health, but I don’t see how I can sit less. I have an hour commute and then I’m at my desk for six hours. In the evening, I sit down for dinner, watch a bit of TV and read. I do get to the gym at least three times a week for an hour. Does that make up for all my sitting? — Allie G., Indianapolis

A: You may think you’re sitting pretty if you work out three to five days a week; after all, that’s what we keep telling you to aim for, along with taking 10,000 steps a day.

(That’s the goal because 80 percent of the health benefits you’ll get from regular physical activity come from going that distance, along with some cardio and resistance workouts.) But getting all the benefits from that physical activity also requires that you stand up for yourself. A new study published in the Annals of Internal Medicine says that even if you get regular exercise, sitting for prolonged periods of time increases your risk for cardiovascular disease by 14 percent, cancer by 13 percent and diabetes by an astounding 91 percent. And if you don’t get regular exercise and also sit for prolonged times, your risk for premature death goes up 40 percent. Folks who sit for more than eight to nine hours a day are at highest risk.

Here are a few solutions to the health traps that come with a modern lifestyle:

■ When you’re at work, stand up for 1-2 minutes every 30 minutes. That increases circulation and cuts the risk of insulin resistance that sitting initiates.

■ Use a standing desk (or put your computer on books) and work standing up.

■ Reduce your on-the-butt time at home. Get up every 30 minutes or at every commercial break and walk for two minutes.

Your goal: Two to three hours LESS “sit time” daily.

■ Get good walking shoes so that your feet feel comfortable with your new standup routine. And make sure your posture is good — shoulders down and back, neck straight and pelvis slightly tucked.

Now you’re standing pretty!

Q: Several of my friends and I are really into cooking, and we want to learn about new foods and experiment with healthier choices. But it’s harder than we thought to get us all together to taste each other’s recipes.

Any suggestions? — Kay W. Santa Fe, New Mexico

A: We have a great idea for you: Get your pals together for a potluck dinner club.

Host the first one yourself, and then the others can take turns hosting after that.

Here’s how it works: Assign each member a dish or course: Appetizers, entrees, side dishes, desserts.

Discuss serving sizes — limit the chicken or fish proteins to 6 ounce servings; provide 1 cup of grains per person; limit starchy veggies to 1/2 cup with other veggies and fruits pretty much unlimited. Fun twist: Everybody makes a dish that’s red or seasoned with three herbs. Then, everyone agrees to eliminate the Five Food Felons from the menu: That’s all added sugars and syrups, any grain that isn’t 100 percent whole and most saturated and all trans fats.

When you avoid the Five Food Felons, you’ll avoid stimulating production of the “I’m still hungry” hormone called ghrelin.

And when you prepare meals with walnuts, avocados, olives and olive oil, plus fruits and vegetables, and protein-rich foods like salmon, anchovies and ocean trout, you’ll stimulate the “I feel full” hormone called leptin.

None of your club members will ever go home hungry.

Your Potluck Club will show everyone that friendly get-togethers don’t have to include unhealthful foods like chicken wings and fried mozzarella. And when you don’t feel sluggish from eating lousy food, you’ll actually have more fun with your friends and family.

]]>http://health.heraldtribune.com/2015/02/24/sitting-lot-harmful-even-exercise/feed/0She doesn’t want to discuss son’s problemshttp://health.heraldtribune.com/2015/02/24/doesnt-want-discuss-sons-problems/
http://health.heraldtribune.com/2015/02/24/doesnt-want-discuss-sons-problems/#commentsTue, 24 Feb 2015 15:42:02 +0000http://health.wp.htcreative.com/?p=24087Read more »]]>Q: My school-age son has emotional and learning problems. Lately his behavior has been very troubling. My well-meaning friends are always asking how he is doing; they don’t know much about his current situation. It’s not something I feel the need to talk to them about, but I don’t want to lie, either. I can’t figure out how to get them to stop without making them feel bad about it.

A: If any of these folks are close friends, I wonder if you are doing more harm than good by shutting them out. Are you afraid of judgment or awkwardness, and in the process cutting yourself off from any semblance of support?

A shoulder, a laugh, a roast chicken or a margarita — sometimes friends can provide much-needed treatment in their own right. Might you benefit from opening up to one or two of them?

If you truly don’t want to talk about things, then it’s just semantics: “Thanks for checking in. Honestly, he’s struggling with some stuff right now, but it’s not something I’m up for talking about. So — what do you think about Kanye vs. Beck?”

Q: I found out, accidentally, that my boyfriend is interviewing for jobs on the West Coast. I just started grad school here on the opposite coast and we agreed we would be here for the three or more years it takes me to finish.

He said this offer was just a small possibility, too good not to interview for, etc. I feel like this is a sign he is ready to break his commitment to me and our plans.

A: I wonder why you created a zero-tolerance policy. There was always going to be the possibility for an exception to the no-West Coast-job-exploration rule.

What if a job offered x amount of dollars, x amount of growth, or x amount of chocolate fountains at the holiday party?

By creating an absolute, you cut off his ability to even discuss his thoughts with you.

Talk to him about how hurt and worried you feel. But acknowledge that your goals can be at odds. In those cases, it’s up to you to listen with respect and experiment with solutions.

Maybe this is a sign he’s losing steam in the relationship. Maybe he felt stifled by the we’re-not-moving pact. Or it could just be this job has chocolate fountains he can’t refuse.

Andrea Bonior, a clinical psychologist, writes a weekly mental health advice column for The Washington Post’s Express and is author of “The Friendship Fix.” For more information, visit www.drandreabonior.com. You can also follow her on Twitter: @drandreabonior.

Brown rice, shown here with chickpeas and chorizo, is a nutritious, gluten-free whole grain. (Photo by Marge Ely for The Washington Post.)

I hope to send my kids into the real world knowing how to cook nourishing food with few kitchen tools, nominal time and a minimal budget.

Well, one obvious place to begin is rice.

I know it sounds boringly basic, but you’d be surprised by how many teenagers and young adults do not know how to cook rice — and how many more believe it should be avoided because it is a white food and a bad carb.

White rice is not nutritious; it is stripped of its outer layers including the bran and the germ, leaving it deprived of its nutrition.

Brown, black, red and wild rice, however, are versatile, nutritious and filling whole grains that provide protein, fiber and more than 15 vitamins and minerals. A half-cup serving of brown rice costs as little as a dime.

Here are all the other reasons I think rice is so nice, and everything else you should know to make it a regular part of your healthful diet.

Rice is a gluten-free grain (and the least allergenic of the whole grains) that provides protein, fiber, B vitamins and minerals such as iron, magnesium and zinc. It provides long-lasting energy because it is a complex carbohydrate that the body digests slowly.

It’s also free of sodium, unhealthful fats and cholesterol.

You’ll find both short-grain and long-grain at the store. Short-grain rice is starchy and therefore softer and stickier once cooked. It is ideal for sushi, paella and risotto.

Long-grain rice contains less starch, so the cooked grains remain separated. It is ideal for saucy dishes, curries and pilafs.

Beyond size, there are several rice varieties:

■ Brown rice is usually sold hulled, which means its outer layer is removed.

The germ, bran and endosperm all remain intact the way they are found in nature, making it a whole grain.

■ Red rice is nutritionally similar to brown rice. It has a nutty flavor and adds a bright color to the plate. Cook and use it as you would brown rice.

Red rice should not be confused with red yeast rice, which is an extract from rice used by some integrative medical practitioners to lower cholesterol.

■ Jasmine and basmati varieties can be processed like any white rice or can be sold as unprocessed brown rice. Both types appear fairly white, so be sure to choose the brown basmati or brown jasmine for nutritional content.

■ Wild rice is higher in protein, vitamin A and folic acid, and lower in carbohydrates and a few minerals than brown. Wild rice is technically a grass, although it is categorized and cooked as a whole grain.

■ Black “forbidden” rice is generally grown in China and has a much chewier, sweeter flavor. The bran layer of black rice contains the same type of beneficial antioxidants found in blueberries.

HOW TO COOK RICE

Rinse rice before cooking to remove any dust or stray particles. Plan for half a cup of uncooked rice per person.

Stove top

Use two cups of water for every cup of rice. Bring water to boil, then add rice and a pinch of salt. Return to a simmer, cover, and lower the heat. Do not remove the cover or stir the rice while cooking, because this can affect the cooking time or cause the rice to become mushy. Brown or red rice generally takes about 40 minutes to cook on the stove top. Drain excess liquid when the rice is done and let sit for 10 minutes before fluffing and then serving. Wild rice usually requires 3 cups of water for 1 cup of grain and takes 45 minutes to an hour to cook on the stove top.

Rice cooker

A rice cooker traps moisture and cooks rice evenly. Follow directions according to the model.

Pressure cooker

Rice can cook in as little as three minutes in a pressure cooker. Follow directions according to the model.

]]>http://health.heraldtribune.com/2015/02/24/virtues-rice-not-white-rice/feed/0Sports drink supplements could cause health problemshttp://health.heraldtribune.com/2015/02/24/sports-drink-supplements-cause-health-problems/
http://health.heraldtribune.com/2015/02/24/sports-drink-supplements-cause-health-problems/#commentsTue, 24 Feb 2015 15:28:53 +0000http://health.wp.htcreative.com/?p=24081Read more »]]> Q: Is it a good idea to buy sports drinks and bottled water with vitamins and minerals added?

A: Even though the amounts of added nutrients in these drinks are typically small, some nutrition scientists are concerned that many people may be ingesting levels of vitamins and other nutrients that are not only unnecessary, but potentially harmful.

Various brands of enhanced waters. (Naum Kazhdan/The New York Times)

“You have vitamins and minerals that occur naturally in foods, and then you have people taking supplements, and then you have all these fortified foods,” said Mridul Datta of Purdue University. “It adds up to quite an excess. There’s the potential for people to get a lot more of these vitamins than they need.”

It found many of the drinks contained vitamins B6, B12, niacin and vitamin C in quantities “well in excess” of average daily requirements for young adults.

Particularly concerning, experts say, is the explosion of beverages marketed for their high levels of antioxidants. The body requires antioxidants to neutralize free radicals that can damage cells and their DNA. But it also uses free radicals to fight off infections and cancer cells, and when antioxidants are present in excess, it can throw things off balance.

“It’s very hard to figure out the logic the manufacturers are using to do this fortification,” said Valerie Tarasuk, a nutrition scientist the University of Toronto.

“There’s no way that the things that are being added are things that anybody needs or stands to benefit from.”

That’s how I arrived in France for the first time. And that’s how I was introduced to Belgian endive.

Madame Gabillet was hosting me for my college semester abroad and she welcomed me pretty much right off the plane into her chilly, dark home.

Dinner was waiting, so we sat right down and rather silently (since I didn’t yet speak a word of French) began the meal. That’s when I saw a vegetable I didn’t recognize.

Was it cabbage? No. But whatever it was, it was bathed in a luscious cream sauce with Gruyere bubbling on top. It was a fitting welcome to what would be a cold and rainy few months.

I understood precious little of what my host family said to me that night, but I did catch the name of the tender, slightly bitter, delight that we ate — Belgian endive.

Madame Gabillet loved Belgian endive (and luckily, as I discovered, so did I).

She served it chopped and sauteed in sweet butter, or sliced and tossed raw in a mustardy vinaigrette, or — my favorite — baked in a white cream sauce with onions and cheese.

Back in the U.S., I saw Belgian endive slowly make its way into supermarkets.

These days you can find it pretty much all year. They look like a cross between an elongated oversized Brussels sprout and a very small head of compacted romaine lettuce, but more yellow. Both Belgian and regular endive are part of the chicory family and sport a slightly bitter flavor.

Each Belgian endive has only 15 calories, but packs tons of fiber, vitamin C and calcium. And for something that sounds so exotically European, it’s downright inexpensive.

So grab a few and try them in some of your favorite recipes that star other greens — raw in place of escarole, sauteed instead of cabbage or kale, simply grilled or roasted with olive oil, salt and pepper and squeeze of lemon.

Or try my version of the dish that started it all — Madame Gabillet’s Belgian endive gratin.

In a medium saucepan over medium heat, melt the butter. Add the onion and cook until translucent, about 5 minutes. Add the garlic and tarragon, then cook until fragrant, another minute. Whisk in the flour and cook, stirring, for 2 minutes. Add the milk, whisking constantly. Cook over medium heat, stirring, until the sauce begins to thicken, about 6 minutes. Turn off the heat, stir in mustard, then season with salt and pepper. Set aside.

Cut off the woody stems of the endive and slice them in half lengthwise. Season them with salt and pepper. Place the endive in the prepared baking dish. Pour the sauce over the endive halves. Cover with foil and bake for 15 minutes. Remove the foil, then sprinkle the cheese evenly over the top.

Return to the oven for another 15 minutes, or until the endive is tender.

If desired, increase heat to broil and broil the gratin until the cheese is bubbly and browned, about 1 minute. Be careful as the cheese will burn quickly. Let cool for a few minutes before serving. Serves four.

Nutrition per serving

■ 230 calories

■ 120 calories from fat (52 percent of total calories)

■ 14 g fat (8 g saturated; 0 g trans fats)

■ 45 mg cholesterol

■ 16 g carbohydrate

■ 3 g fiber

■ 6 g sugar

■ 12 g protein

■ 540 mg sodium

Food Network star Melissa d’Arabian — melissadarabian.net — is an expert on healthy eating on a budget. She is the author of the cookbook, “Supermarket Healthy.”

So, chocolate milk over regular milk? Both are good choices unless they cause digestive issues, says nutritionist Rebecca Scritchfield. But flavored milk — chocolate, strawberry or vanilla — has a more beneficial ratio of carbohydrates to protein for muscle recovery and rebuilding.

In other words, there is nothing magical about the cacao itself in chocolate milk; it’s the extra carbs — the sugars — that create the perfect potion.

“Milk alone may not be enough carbs or calories, but it can be enhanced to be adequate,” Scritchfield says.

The ratio to aim for is 4 grams of carbohydrates to 1 gram of protein, according to Joel Stager, professor of kinesiology at Indiana University. Nelson says that immediately on entering the body, milk creates spikes in insulin that help transport sugar into the muscle, where it becomes glycogen. It also stimulates muscle protein repair and growth.

The amount of carb-infused milk recommended can range from 8 to 16 ounces, depending on the intensity, frequency and duration of exercise as well as gender, size and age.

An eight-ounce glass of 2 percent milk has 12 grams of carbs and 8 grams of protein. Nowhere near the recommended 4:1 ratio. That means you would need to add about 20 grams of carbohydrates. For example, a small banana has about 20 grams of carbs. Voila! There is your flavored post-exercise sports drink.

– Gabriella Boston, The Washington Post

]]>http://health.heraldtribune.com/2015/02/24/milk-offers-benefits-muscle-recovery/feed/0Do fish oil supplements really help?http://health.heraldtribune.com/2015/02/24/fish-oil-supplements-really-help/
http://health.heraldtribune.com/2015/02/24/fish-oil-supplements-really-help/#commentsTue, 24 Feb 2015 14:13:19 +0000http://health.wp.htcreative.com/?p=24064Read more »]]>Q: I’ve avoided taking fish-oil pills because I didn’t like the taste in my mouth hours later. Now I’ve been reading that fish-oil pills don’t actually live up to their promise of preventing heart disease. Can I skip them?

A: The answer, as for many nutrition topics, has evolved as research has revealed fresh findings.

“Nothing in nutrition is set in stone. We just don’t yet know the details of everything various nutrients do, let alone exactly how much people need and how to account for individual differences,” says Catherine Price, author of “Vitamania: Our Obsessive Quest for Nutritional Perfection.”

Keep in mind that research in this area is aimed squarely at reducing cardiovascular disease, particularly heart disease and strokes.

Fish, red meat, peanut butter, avocados and other foods contain different types of fats, including saturated fat and the two main categories of unsaturated fats, polyunsaturated and monounsaturated. Even the highly esteemed olive oil contains a small amount of saturated fat.

We all need to eat some fat. Fats provide vitamins A, D, E, and K and, among other functions, help maintain healthy skin.

But the message to cut as many calories from fat as you can is from a bygone era. Today the focus is on quality.

In a nutshell, this translates to: Don’t eat too few (less than 20 percent) or too many (no more than 35 percent) calories from fat, and make the fats you eat more healthful ones.

“Research shows that preferentially replacing polyunsaturated fats for saturated fats provides the greatest impact on reducing cardiovascular disease,” says Penny Kris-Etherton, Penn State University nutrition professor and spokeswoman for the American Heart Association. Monounsaturated fats come in second place and healthful sources of carbohydrates come in third.

Omega-6 and omega-3 fats are the two main types of polyunsaturated fats. Liquid vegetable oils, such as corn, soybean and sunflower oils, contain mainly omega-6 fats. Omega-3 fats are found in plant-based foods such as canola and soybean oil, flax oil and seeds, and walnuts or walnut oil, and, as you know, fish.

Early studies showed remarkable benefits of fish-oil supplements in preventing repeat heart attacks and strokes and sudden death from heart disease. But more recent research has not duplicated these dramatic benefits, though it has shown some.

Consuming sufficient amounts of omega- 3s from fatty fish remains an important goal for heart health, along with attention to eating more plant-based omega-3s.

“People don’t eat sufficient amounts of either,” Kris-Etherton says.

Suzanne Steinbaum, director of the Women and Heart Disease Center at Lenox Hill Hospital in New York and co-founder of the Global Nutrition & Health Alliance, recommends fatty fish such as salmon, mackerel, herring, trout, sardines and tuna.

Why the focus on eating fish rather than swallowing fish-oil supplements?

“Fish provides a good source of protein along with vitamin D, B vitamins, potassium and other nutrients,” Kris-Etherton says.

The answer to your question about whether you can skip fish-oil supplements depends greatly on your willingness to eat a sufficient amount of fish each week — about eight ounces — along with your health status.

Kris-Etherton recommends one gram per day of a fish-oil supplement for healthy individuals who don’t eat fatty fish. Steinbaum recommends one gram per day for people at risk of or with heart disease, and more for those with elevated triglyceride levels.

And, as always, it’s a good idea to discuss your individual health status and disease risks with your health-care provider before starting a supplement.

ANSWER: The textbook answer is 20 percent to 40 percent, but in reality, the answer is very complicated, as it depends on total body and intracellular calcium, vitamin D levels, presence of phosphates in food and other factors. The short answer is that it's usually exactly what it needs to be when things work properly. If the body is deficient in calcium, then absorption is maximal, but still most calcium in food is not absorbed.

Calcium is important to good bone health, and the osteoporosis pamphlet furnishes details on how to prevent this universal condition. Readers can obtain a copy by writing: Dr. Roach -- No. 1104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name address. Please allow four weeks for delivery.

DEAR DR. ROACH: I am a 74-year-old fit woman who had an aortic valve replacement with a bovine valve in April 2014. After surgery, I was put on 200 milligrams of amiodarone, as well as 2-5 milligrams of Coumadin and 25 milligrams of Lopressor. I also take 80 milligrams of diovan once a day. I have been in A fib from before surgery until six weeks ago, when I finally had normal sinus rhythm.

The amiodarone seems to have caused thyroid and kidney problems, as well as a problem with my balance and gait. I am extremely exhausted on exertion, but feel fine once I sit down and rest for five minutes.

Is there anything else that can be taken instead of the amiodarone? I took digoxin before surgery. -- C.P.

ANSWER: Atrial fibrillation is a common heart issue involving an irregular and chaotic heart rhythm, sometimes associated with valve abnormalities (especially of the mitral valve). But it's been known to occur in otherwise healthy hearts as well. Sometimes, physicians use medication to get people out of A fib or to keep them in normal sinus rhythm once they are in it. Amiodarone probably is the most effective of these medications, but it does have side effects, especially when it comes to the thyroid and kidneys (as you have found). It also can affect the lungs.

There are other medication options to try to keep the heart in normal rhythm -- such as dofetilide, propafenone, flecainide and sotalol -- but none of these is as effective as amiodarone. Digoxin, which you took before surgery, does not treat the rhythm disturbance of A fib, but does keep the heart rate under control in most people.

Difficulty breathing on exertion has a very long list of possible causes, and there may be more that is going on. I would recommend you visit your regular doctor and your cardiologist (if they are different) and make sure you have had an evaluation.

DEAR DR. ROACH: I'd like to comment on the exchange of letters about mercury in (and out) of thermometers. The advice given by the Poison Control Center is OK but insufficient. Elemental mercury indeed would sink to the bottom of the cup. However, it does have a significant vapor pressure and can produce inhalable mercury. When rinsed down the drain, the mercury could reside in the drain trap and emit mercury vapor. This is why all sources of "escaped" mercury, including spent or broken CFL light bulbs, should be recovered and recycled. -- R.B.

ANSWER: Thank you for writing. Because elemental mercury can vaporize, it is important to clean up properly. Small mercury spills can be cleaned according to instructions from the department of health (such as https://www.health.ny.gov/environmental/chemicals/hsees/mercury/brochures/cleanup.htm). Larger spills require professional help. Mercury in a drainpipe trap (where my reader's mercury may have ended up) should be removed by a plumber and disposed of properly.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/02/23/much-calcium-body-absorbs-difficult-say-certainty/feed/0For some terminal patients, routine procedures can be unnecessaryhttp://health.heraldtribune.com/2015/02/20/terminal-patients-routine-procedures-can-unnecessary/
http://health.heraldtribune.com/2015/02/20/terminal-patients-routine-procedures-can-unnecessary/#commentsFri, 20 Feb 2015 10:00:42 +0000http://health.wp.htcreative.com/?p=23940Read more »]]>DEAR DR. ROACH:My mother has stage 4 cancer. She just went to a dermatologist, who performed Mohs surgery on her nose. I am BEYOND upset by this unethical behavior. The country is already deeply in debt, and Medicare is paying for this? Unconscionable! Not to mention the pain and suffering of my mother, who is now at risk of a secondary infection. I was sickened by the entire ordeal. -- J.B.

ANSWER: I agree with you completely that often patients with terminal diseases receive unnecessary care. There have been studies clearly documenting this. However, the studies don't answer why, in a particular case, a physician performed these treatments, which add only pain, anxiety and expense.

I suppose it is possible that the motivation is simple greed; however, I still have enough faith in my colleagues that I think that is a very unusual reason; I think it's far more likely that a specialist just doesn't see the big picture. There's an old expression that when all you have is a hammer, the whole world looks like a nail, and I think some specialists see a problem and fix it without realizing that the problem they are fixing isn't likely to ever cause symptoms.

For example, primary-care doctors order unnecessary tests, especially screening tests. I see mammograms ordered for women with advanced colon or ovarian cancer who are in palliative care, and this makes no sense. I have heard some physicians mention that insurance companies monitor the frequency of "quality indicators," such as mammograms, which affect their ratings and reimbursement. That's an example of a well-meaning system motivating wrong behavior.

I should emphasize that not all care for terminal patients is useless. If the goal is to improve quality of life or reduce suffering, then I am all for it, after a consideration of the costs (pain and inconvenience as well as dollar costs).

DEAR DR. ROACH:Could you please discuss the use of Prevagen for Alzheimer's disease? My chiropractor wants me to take it because my mother had Alzheimer's. She says her father is doing well and not progressing. What do jellyfish have to cause this result? I have not heard any research from medical facilities that back this up. -- L.C.

ANSWER: I could not find any peer-reviewed literature that supports the use of Prevagen for Alzheimer's disease or other neurological disease. The company that makes the product has unpublished data on its website that suggests there may be a benefit in memory. There is also a study in rats that suggests the active protein, apoaequorin, may protect nerve cells against loss of glucose and oxygen. This protein was originally identified from luminescent jellyfish but is made synthetically in Prevagen. The rat research result is surprising, since proteins are normally broken down in the GI tract, and normally would not be expected to have activity in the brain.

There are reports made to the Food and Drug Administration of serious adverse events from this product. A supplement is not required to show its benefit; in fact, the product information for Prevagen clearly states that it is "not intended to diagnose, treat, cure, or prevent any disease." Although I understand why people would be interested in trying to prevent or treat Alzheimer's disease, I don't recommend using this product until there is clear, peer-reviewed evidence that it is better than placebo. In my mind, taking any treatment -- drug or supplement -- to prevent a condition requires the highest level of certainty.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/02/20/terminal-patients-routine-procedures-can-unnecessary/feed/0Healthy diet panel: Eat less meathttp://health.heraldtribune.com/2015/02/19/healthy-diet-panel-eat-less-meat/
http://health.heraldtribune.com/2015/02/19/healthy-diet-panel-eat-less-meat/#commentsThu, 19 Feb 2015 20:41:57 +0000http://health.wp.htcreative.com/?p=24038Read more »]]>The country's foremost nutrition advisory panel is taking a stand against meat: Americans should eat less of it, top experts say, in order to protect the environment.

The recommendation could have a significant impact on the amount of meat people eat — as well as the environmental impact of a carnivorous nation.

n this April 24, 2014 file photo, a variety of healthy fruits and vegetables are displayed for sale at a market in Washington. Drink less sugary soda, but an extra cup of coffee or two is OK. So are eggs. And as always, don’t forget your vegetables. A government advisory committee is recommending the first real limits on added sugars, but backs off stricter ones for salt and cholesterol intake. It calls for an environmentally friendly diet lower in red and processed meats. (AP Photo/J. Scott Applewhite, File)

"We're not saying that people need to become vegans," said Miriam Nelson, a professor at Tufts University and one of the committee's members. "But we are saying that people need to eat less meat."

The panel's findings, which were released to the public in the form on a 572 page report Thursday, specifically recommend that Americans be kinder to the environment by eating more plant-based foods and fewer animal-based foods. The panel is confident that the country can align both health goals and environmental aims, but warns that the U.S. diet, as currently constructed, could improve.

"Consistent evidence indicates that, in general, a dietary pattern that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods is more health promoting and is associated with lesser environmental impact than is the current average U.S. diet," the report says.

Americans, though they are eating less meat than they have in the past, are still eating too much. The problem, which the committee's findings reflect, is that all that meat eating is still having too much of an impact on the environment.

Meat eaters have been linked to considerably larger carbon footprint than vegetarians. And the livestock industry has been associated with a considerably larger carbon footprint than any other food industry. The combination of those two realities, along with the committee's understanding that diets lower in meat consumption, especially red and processed meat consumption, tend to be more healthful, has forced the committee's hand.

The group, which has been mulling a number of changes to the dietary guidelines, has traditionally advised the government about healthy eating choices which, until now, have only reflected what the group views as a diet that is healthy for humans. The new recommendations mark a major break from the past, and offer a glimpse into what the guidelines might look like in the decades to come.

"If we're thinking about the foods that are culturally appropriate, we need to start thinking about what's sustainable," said Nelson. "Other countries have already started doing this_including sustainability in their recommendations. We should be doing it too."

The meat industry, for its part, vehemently objects to the notion that Americans should be eating less meat. The North American Meat Institute has repeatedly questioned whether the nutrition panel should be allowed to include sustainability concerns in its recommendations, and challenged the notion that meat negatively impacts the environment.

"If our government believes Americans should factor sustainability into their choices, guidance should come from a panel of sustainability experts that understands the complexity of the issue," Barry Carpenter, the chief executive of The North American Meat Institute, said in a statement.

The official dietary guidelines, which are updated every five years, won't be released until later this year, after the department of Health and Human Services considers the advisory committee's recommendations. The panel's suggestions are, ultimately, suggestions, which the government doesn't have to act upon. But historically, the government has incorporated the panel's suggestions, especially those that recommend changes and updates, into its guidance.

If the government acts upon the panel's recommendations to suggest lower meat intake, the impact on the meat industry will be significant. While Americans don't necessarily heed the dietary guidelines ahead of each meal, the guidelines do influence prevalent health narratives. They also help dictate what is on the menu of federal feeding programs, like the school lunch program.

]]>http://health.heraldtribune.com/2015/02/19/healthy-diet-panel-eat-less-meat/feed/0Bake sales are out as school fundraisershttp://health.heraldtribune.com/2015/02/17/bake-sales-school-fundraisers/
http://health.heraldtribune.com/2015/02/17/bake-sales-school-fundraisers/#commentsTue, 17 Feb 2015 16:08:18 +0000http://health.wp.htcreative.com/?p=24012Read more »]]>When it comes to school fundraisers, bake sale tables loaded with sugary goodies are out. Fun runs, auctions and sales of healthier treats are in.

When it comes to school fundraisers, bake sale tables loaded with sugary goodies are out. Fun runs, auctions and sales of healthier treats are in. (AP Photo/Charlie Riedel, File)

Government rules requiring many schools to hold more nutritious fundraisers, along with a trend toward healthier eating in schools, could mean trouble for the long-beloved bake sale. In response, schools are selling everything from fruit to kid-friendly shoelaces.

In Dallas, physical education teacher Sharon Foster says her school, James Bowie Elementary, stopped selling chocolate bars and started selling Y-Ties — elastic shoelaces that don’t have to be tied.

Parent Susan Fox Pinkowitz said she helped her children’s elementary school, University Park Elementary in Denver, move from a candy-filled annual carnival to a fun run and carnival that offers apples and protein nut bars. She said the new fundraiser brings in as much as $12,000 annually, three or four times the amount raised by the old event.

Not everyone is on board. Missy Latham, a parent in Greenville, South Carolina, says bake sales are profitable.

“It’s kind of absurd that one week a year you couldn’t sell something like that without the government mandating that it’s OK,” Latham said.

The Agriculture Department rules, which kicked in last summer, require all foods sold on school campuses during the school day to meet certain nutrition standards. The rules include fundraisers, if states don’t exempt themselves. In all, 22 states have used the exemptions, according to the National Association of State Boards of Education.

Florida allows exemptions for five days in elementary schools, 10 days in middle and junior high schools, 15 days in senior high schools, and 10 days in schools that combine those grades. No exempted fundraiser can take place less than 30 minutes after the last meal period.

Last week, Arizona Superintendent of Public Instruction Diane Douglas said the state would move to exempt fundraisers after she heard that a school couldn’t sell snow cones.

“The thought that a federal bureaucrat knows better than parents what they can feed their own families is condescending and reprehensible,” Douglas said.

The federal rules don’t apply to food that is intended to be consumed at home or outside of school — so kids can still sell fundraiser mainstays like frozen pizza, frozen cookie dough and chocolate bars.

]]>http://health.heraldtribune.com/2015/02/17/bake-sales-school-fundraisers/feed/0Milk is good, but not 'magic'http://health.heraldtribune.com/2015/02/17/milk-good-not-magic/
http://health.heraldtribune.com/2015/02/17/milk-good-not-magic/#commentsTue, 17 Feb 2015 15:49:55 +0000http://health.wp.htcreative.com/?p=24004Read more »]]> Q: What do scientists currently know about the health benefits of milk?

A: The U.S. Department of Agriculture recommends daily consumption of fat-free or low-fat milk or dairy products, at 2 to 2 1/2 cups for younger children and 3 cups a day for older children and adults.

But some scientists question previous statements about milk’s benefits.

For example, some researchers have noted low fracture rates in Asian countries where little milk is consumed. And some studies have linked milk to risk of ovarian and prostate cancers — though many scientists believe more research is needed before drawing conclusions.

Last year, a Swedish study in a British medical journal found women who drank three or more glasses of milk a day died at a nearly twice the rate of those who drank less than one glass a day.

Broken bones were more common in women who were heavy milk drinkers, too. Other dairy products were not linked to such problems. The study’s lead author said differences in the American diet might diminish the kind of potential harms seen in the Swedes in his study.

“The idea that milk is ‘a perfect food’ has been discredited,” said David Levitsky, a nutrition and psychology expert at Cornell University. But it remains a rich source of calcium and is still viewed as a valuable part of a well-balanced diet — especially for kids, he said, adding that the bone-building benefits of milk fall off for people during their 20s.

“It’s a good food,” Levitsky said. “But you shouldn’t look at it as a magic food.”

I talk to my kids every day about eating a rainbow of produce in order to get all the nutrients they need.

But you know what color is left out of the rainbow? White.

That is, at least according to my 7-year-old twins when I presented cauliflower to them at the dinner table. What a shame. Have we lost all the love for the contributions of white veggies like onions and cauliflower and all their good-for-you nutrients? So what better time than winter to celebrate an oft-overlooked white veggie — the turnip! The turnip is misunderstood and passed over all too quickly. Raw, its flavor is sharp, even unpleasant. But as it cooks the turnip softens into a milder, earthy, slightly sweet flavor.

Nutritionally speaking, the turnip is a rock star. A large turnip has only 50 calories, but is jam packed with vitamin C, as well as smaller amounts of all sort of other nutrients. And turnips are a two-for-one veggie, meaning you buy the root and you get the turnip greens for free.

Don’t throw those greens away. They are nutritional powerhouses, too! Wash them, chop them, then saute, steam or braise them as you would any other green. And dunking them in a pot of boiling water for a minute helps remove the bitter taste.

Despite all this great news, outside of pockets of regional turnip lovers, most Americans don’t turn to the turnip very often.

A helpful strategy for including turnips at the novice’s table is to pair it with a fellow root veggie. A good way to do this is to combine them in a hash, puree or soup, such as in this roasted garlic, turnip and sweet potato soup.

Tucking into a bowl of veggie-based soup is not only a great health move, it’s also a perfect way to begin a comforting wintery meal.

Enjoy the turnip soup as is, or use it as inspiration to match your favorite flavor profile, by adding curry powder, smoked paprika or even orange zest and cumin.

ROASTED GARLIC, TURNIP AND SWEET POTATO SOUP

Ingredients

1 large sweet potato, peeled and diced

1 large turnip, peeled and diced

3 tablespoons olive oil

8 cloves garlic, whole and peeled

2 shallots, sliced

2 teaspoons chopped fresh thyme

4 cups low-sodium chicken or vegetable stock

1/4 cup white wine

Salt and ground black pepper

1 tablespoon balsamic vinegar

1/2 cup plain low-fat Greek yogurt

Chopped chives or scallions, for garnish

Method

Heat oven to 400 F. Line a baking sheet with foil and mist with cooking spray.

In a large bowl, combine the sweet potato and turnip. Drizzle with 2 tablespoons of the olive oil. Spread the sweet potatoes and turnip in an even layer on the prepared baking sheet. Roast for 15 minutes.

Meanwhile, in the same bowl, toss the garlic, shallots and thyme with the remaining

1 tablespoon of olive oil. After the sweet potatoes and turnip have roasted for 15 minutes, use a spatula to turn the pieces. Add the garlic and shallot mixture to the pan, then roast for another 20 minutes.

In a large saucepan over medium heat, combine the stock and wine and bring to a gentle simmer. Add the roasted vegetable mixture and simmer until the sweet potatoes are very tender, about 10 minutes. Remove the pan from the heat. Working in batches if necessary, transfer the mixture to a blender. Using caution when blending hot liquids, blend until smooth.

Return the soup to the pan and reheat for several minutes, if needed, over medium. Stir in the vinegar, then season with salt and pepper. Add water if soup is too thick. Ladle the soup into serving bowls, top each serving with a bit of yogurt and chives or scallions. Serves six.

Nutrition per serving:

■ 140 calories

■ 70 calories from fat (50 percent of total calories)

■ 8 g fat (1.5 g saturated; 0 g trans fats)

■ 5 mg cholesterol

■ 13 g carbohydrate

■ 2 g fiber

■ 5 g sugar

■ 4 g protein

■ 270 mg sodium

Food Network star Melissa d’Arabian — melissadarabian.net — is an expert on healthy eating on a budget. She is the author of the cookbook, “Supermarket Healthy.”

]]>http://health.heraldtribune.com/2015/02/17/add-whites-rainbow-food-eat/feed/0To hit goals, don’t be such an optimisthttp://health.heraldtribune.com/2015/02/17/hit-goals-dont-optimist/
http://health.heraldtribune.com/2015/02/17/hit-goals-dont-optimist/#commentsTue, 17 Feb 2015 15:01:02 +0000http://health.wp.htcreative.com/?p=23997Read more »]]>It’s that time of year when New Year’s resolutions begin to fade, and even the best-laid plans can become sidetracked as life gets busy.

But as psychologists and behavioral economists have found reasons why it’s so easy to let good intentions slide, they’ve also come up with tools to help.

As counterintuitive as it may sound, many resolutions fail due to positive thinking, says Gabriele Oettingen, a psychologist at New York University. Her research has shown that optimistic thinking can actually hamper your drive to succeed.

In one study, her research team asked a group of 134 dieters to list a goal they thought they could attain in the next two weeks. Some were also asked to imagine themselves succeeding, while others were told to think about their goal but also obstacles that might stand in their way — an exercise called mental contrasting.

Two weeks later, the people who had anticipated potential roadblocks reported that they had eaten fewer calories than those who had only envisioned succeeding.

“We found that positive dreams and fantasies are not only not helpful, but they might actually hurt,” Oettingen says.

“It seems that people who are positively fantasizing about the future might be enjoying future success in the here and now, and they can become so relaxed that they don’t get serious about addressing obstacles.”

In her new book, “Rethinking Positive Thinking,” Oettingen outlines a mental contrasting strategy called WOOP, for “wish, outcome, obstacle, plan.”

First, you identify your wish or goal; then you take a moment to imagine how great it will feel to attain it; next you think about obstacles you might encounter and finally you build a plan to overcome these barriers. Smartphone users can download a WOOP app to help them save goals and plans and track progress.

Some goals fail when they fall prey to a phenomenon that behavioral economists call hyperbolic discounting, in which immediate rewards seem more alluring than further-off ones, even if they’re smaller.

“The idea is that our decision-making is distorted by the immediate consequences,” says Daniel Reeves, a game theorist who, with his wife, Bethany Soule, founded a company called Beeminder to help people overcome this bug in our mental processing.

Users sign up and commit to a goal, then use Beeminder to track progress. Marking your goal on Beeminder becomes a tiny pleasure, like crossing something off a to-do list. And after a free period, the service charges your credit card an amount you’ve voluntarily pledged if you get off track.

The program, which can be used online or via smartphone apps, integrates with and automatically uploads data from more than a dozen apps and devices.

Stickk is another goal tracker that uses financial incentives for motivation. After setting your goal, you set the stakes, in dollars, and then select a person to keep you honest. Your referee must confirm to Stickk that you’ve done what you’ve said, or else you’re on the hook for the money.

If you fail, the money can go to a friend, a foe, a charity or what Jordan Goldberg, who founded Stickk in 2008 with two Yale behavioral economists, calls an “anti-charity”— a cause that irks you.

“If you’re pro-gun-control, we’ll send your money to the NRA, or vice versa,” he says. “We see the highest success rates among users who choose this option.”

]]>http://health.heraldtribune.com/2015/02/17/hit-goals-dont-optimist/feed/0California dreaming: what starts here spreadshttp://health.heraldtribune.com/2015/02/17/california-dreaming-starts-spreads/
http://health.heraldtribune.com/2015/02/17/california-dreaming-starts-spreads/#commentsTue, 17 Feb 2015 14:26:37 +0000http://health.wp.htcreative.com/?p=23988Read more »]]>I’m in California now, on a pilgrimage through the golden state where Healthy Lifestyle got its start. Countless, boundless health and wellness movements sprouted here more than 50 years ago, and then bonged out across the country.

“Whatever starts in California, unfortunately has an inclination to spread,” president and peacemaker Jimmy Carter once said.

Unfortunately? C’mon, Jimmy. Joke all you want about the fruits and nuts of California, but this state certainly gets it right when it comes to health, happiness and the pursuit of consciousness — a must for graceful aging, and exiting.

Fitness and physical fun, the mind body connection, meditation and mindfulness, workplace wellness, conscious capitalism (now rebranded as sacred commerce) — all these concepts and many others involving crystals and comfortable shoes were part of the Human Potential Movement, which began here in California in the ’60s, at a place called Esalen, along the breathtaking coast of Big Sur. It’s there that I recently treated myself to a late-night healing sound bath by a naked man playing the didgeridoo. But I digress.

So here’s my update from California, the state that made the altered state an honored ritual of self-discovery:

■ Taste of the future? I’ve eaten out a million times but I’ve never seen anything like this printed on a menu, spotted at “Chaya Venice” in Venice, California, where the Prickly Pear Puree lemonade is primo.

“Chaya greatly values our hardworking team’s quality of life and well-being. To emphasize this commitment there is a 3 percent charge added to all checks. Thank you for supporting a healthier restaurant.” “What’s this?” I asked my young George Clooney-esque waiter. “A 3 percent tax to benefit your health and well-being?”

“Yes,” he said, smiling from ear to multipierced ear. It’s a new law in California. Restaurant owners don’t normally provide wait staff with health insurance, so the customer is being asked to help out. Not asked, told. That’s how taxes work.

Holy Alice Waters! This is how food should taste. Foodism got its start here in California, and lettuce wraps are a brilliant way to cut back on the carbs in your life. These days, consciousness about eating real food, local food, is spreading from Maui to Maine. Farmers’ markets are everywhere. Airport food shops sell raw almonds and Greek yogurt. It’s what progress looks like.

And the 3 percent unexpectedly added to my bill is a kind of progress, too, if you value helping others lead a less stressful life. I think of it as a kindness tax.

I’m grateful I can eat such beautiful food, and my adorable waiter is grateful he’s got some wellness care he didn’t have before.

■ Yoga grows . . . and slows. Yoga is another multibillion-dollar big business that was here before it was everywhere, and whenever I come to California, I check in with my local yoga drones to see what’s happening now.

And here’s what I hear: Slow yoga is quickly catching on, not just in California, but also all across the country. Older yogis who used to think nothing of putting their knees behind their ears, and their noses on their toeses, are much more respectful of their hips, their backs, their breath, their vulnerable bodies.

Sure, there are plenty of people, mostly young, mostly checking every move in the mirror, still doing power yoga, gym yoga, flying from pose to pose. But a smarter practice is a sustainable practice, a yoga that moves more slowly and goes more deeply, a yoga that asks you to focus inward and feel what’s going on inside your own unique body.

It’s called, variously, somatics or restorative yoga or slow yoga or yin yoga. Look for it at your local yoga studio, which reminds me of the nuttiest/ fruitiest sign I’ve seen out here.

It was posted in the window of a yoga studio in a posh part of LA, and I took it as a sign to stay real: “Hot Yoga. Yoga Flow. No Chanting.”

Marilynn Preston is a fitness expert, personal trainer and speaker on healthy lifestyle issues. She has a website, marilynnpreston.com, and welcomes reader questions, which can be sent to MyEnergyExpress@aol.com.

]]>http://health.heraldtribune.com/2015/02/17/california-dreaming-starts-spreads/feed/0Bread's bad raphttp://health.heraldtribune.com/2015/02/17/breads-bad-rap/
http://health.heraldtribune.com/2015/02/17/breads-bad-rap/#commentsTue, 17 Feb 2015 13:57:12 +0000http://health.wp.htcreative.com/?p=23980Read more »]]> It’s become popular to think of foods as either good or bad, something to eat or to avoid.

Carbohydrates, which had their moment as a good food back when fat was the bad guy, are now being blamed in part for the epidemic of obesity, diabetes and heart disease. And a slew of diet books proposes that you will feel better and be healthier if you never eat bread, pasta or sugar again. But are carbs really so bad? Science makes the answer pretty clear: no.

While bread, pasta and sugar are hard-to-resist sources of calories without much in the way of nutrition, other carbohydrate-heavy foods — whole grains, legumes and fruit — are nutrient-rich. Carbohydrates can play a healthful role in your diet or they can be your undoing, depending on which, and how many, you eat. The biggest beef against carbs is that it’s easy to eat too much of them, which is a problem because it can lead to weight gain and because they can crowd out more-nutritious foods. There’s also speculation that the way our bodies digest sugar and certain processed grains such as those found in white bread and white rice makes us hungry again soon after eating.

“Carbs aren’t the enemy,” says Julie Jones, a professor emeritus of food and nutrition at St. Catherine University in St. Paul, Minn. “Overconsumption, of anything, is the enemy.”

Even so, the good-or-bad notion gets traction.

“It’s easier for a lot of people to cut off whole categories of food than to eat moderately,” says Marion Nestle, a professor in New York University’s department of nutrition, food studies and public health.

And a lot of people report that they feel better and lose weight when they cut out sugar and refined carbohydrates, she says. Yet there’s no reason, she adds, that bread, pasta and plain old sugar should be completely off-limits, as some popular diets recommend. In moderation, they’ll do you no harm.

MOLECULAR SCIENCE

To help navigate the world of carbs the foods, it’s helpful to spend a little time with carbs the molecules.

Carbohydrates run the gamut from very simple molecules that your body breaks down easily to very complex molecules that your body breaks down more slowly, or not at all. Since carbohydrates that you eat are mainly converted to glucose, the sugar that every cell of your body can use for energy, the faster the carbohydrate is digested, the quicker it’s turned into blood sugar.

There are questions about possible negative health effects of some carbs, such as fructose, which is found in sugar and high-fructose corn syrup, and galactose, which is found in milk. But the question of how carbs affect health is mostly focused on how quickly and efficiently the body can break the molecule down and deliver glucose to the bloodstream.

But you don’t eat carbohydrates; you eat food — so it’s useful to categorize foods by the type of carbohydrates that predominate.

Simple-carb foods are those that your body breaks down quickly and easily, such as sweeteners (sugar, honey, maple syrup) and refined grains (white flour, pasta, white rice). These are the carbs that tend to get the bad rap because they cause spikes in blood sugar.

Complex-carb foods, which include whole grains and legumes, have large, complex molecules that are more difficult to digest and consequently don’t cause the same rapid increase in blood sugar.

The simple/complex classification isn’t perfect. Many fruits and vegetables contain both types of carbohydrates: Some get broken down quickly, others more slowly. And it’s not always true that whole foods are digested slowly while refined foods are digested quickly. Potatoes, for example, have lots of carbohydrates in the form of starch, which is broken down quickly.

HOW BAD IS SUGAR?

In the complex world of food, it’s refreshing to find an idea on which there is universal agreement: Everyone thinks it’s important to limit sugar consumption. There is, however, a range of opinion on just how bad sugar is.

Some doctors and scientists believe that the problem with sugar is that it’s empty calories — tasty empty calories that go down very easily, particularly in sweetened drinks. Others believe that the ease with which our bodies turn sugar in soda into sugar in our bloodstream messes with our metabolism in a way that disposes us to overeat.

Because the carbohydrates in refined grains — bread, white rice, pasta — come packaged with some fiber, some protein and even a few other nutrients, their calories aren’t quite as empty, and the speed with which they’re digested varies. (Refined flour is also fortified with folate, essential to reducing the risk of fetal neural tube defects.) White bread, for example, lets loose a flood of glucose, so your blood sugar spikes, but pasta, particularly if it’s not overcooked, doesn’t have that effect. Although the ingredients of the two foods are almost identical, pasta has a difficult molecular structure that your body can’t break down as quickly.

There is a measure for how much a particular food increases your blood sugar: the glycemic index, or GI. When carbohydrates in a food get converted quickly, that causes a spike in insulin, which your pancreas releases to prompt cells to absorb the glucose. The hormones that your body releases in response can make you feel hungry. The higher the GI, the higher the blood sugar level. If you eat high-GI foods often, the repeated stressing of your insulin-producing machinery may have other effects, such as increasing your risk for diabetes.

There is disagreement about the importance of the glycemic index. While some scientists believe it’s an essential measure of diet quality and while many diets have been designed around it, Nestle isn’t sold.

“I’m not a great believer in its importance,” she says, and points out that the GI measures foods eaten alone, and what you eat with your carbs affects subsequent blood sugar levels.

“People don’t usually eat those things without anything else,” Nestle points out. “They put butter on their bread. They put cheese on their pasta.”

Both have fat, she explains, and fat slows down the glucose-delivery mechanism — which is why the glycemic index of bread with butter is lower than that of bread alone.

Glycemic index response is also affected by how the food was cooked (not only the method but how long it was cooked), how thoroughly you chew and other factors, says Susan Roberts, director of the energy metabolism laboratory at Tufts University in Boston. A person can have a different response to the same food from one day to another.

GI VS. JUNK FOOD

Why is it that when researchers look at the diet of the population as a whole, they find that a low-GI diet has benefits, but when they bring people into the lab and feed them low- and high-GI diets, they don’t find those advantages?

Experimental diets don’t include lots of junk; instead, they use the most healthful of the high-GI foods, because the point is to change as little as possible about the diet to get at the effect of only the glycemic index.

If you eat a lot of junk food, your diet is definitely high-GI. As Julie Jones says, “We don’t need any kind of index to tell us we shouldn’t eat Doodles, Ding-Dongs and doughnuts.”

Roberts says that it could be the higher nutrient levels of low-GI foods, and not the glycemic response, that’s responsible for the lowered disease risk. Luc Tappy of Switzerland’s University of Lausanne, who chairs the committee revising carbohydrate recommendations for France, says we don’t have conclusive evidence of the glycemic index’s importance. He calls it an “open question.”

When questions are open, it’s often hard to know what to eat. But everyone agrees that limiting sugar is important.

And Jones points to the U.S. government’s Dietary Guidelines for Americans as a simple rule for other carb-heavy foods: Make half your grains whole.

WHAT’S A FODMAP?

It’s hard to talk about carbs without talking about gluten. Gluten is not a carb; it’s a mix of proteins found in wheat and close relatives. It gives bread its elasticity, but it also sets off the immune system of people with celiac disease.

Some people who feel better when they don’t eat wheat may assume they have gluten sensitivity. But some researchers believe it’s not the gluten; it’s fermentable oligosaccharides, disaccharides, monosaccharides and polyols — FODMAPs.

FODMAPs are a group of carbohydrates that don’t get broken down in the small intestine. Instead, they pass through to the large intestine. The process by which FODMAPs are fermented can cause gastrointestinal distress: diarrhea, bloating, flatulence and constipation. Wheat and rye are high in FODMAPs, as are onions, garlic, apples, stone fruit, and pistachios.

But there’s a problem with a low-FODMAP diet. The fermentation painful for that 10 percent is good for your gut because it stimulates growth of the bacteria associated with digestive health. If your gut can handle FODMAPs, foods that contain a lot of them can be very good choices.

]]>http://health.heraldtribune.com/2015/02/17/breads-bad-rap/feed/0Check in with doctor on checkup schedulehttp://health.heraldtribune.com/2015/02/12/check-doctor-checkup-schedule/
http://health.heraldtribune.com/2015/02/12/check-doctor-checkup-schedule/#commentsThu, 12 Feb 2015 10:00:59 +0000http://health.wp.htcreative.com/?p=23852Read more »]]>DEAR DR. ROACH: I normally go to the dermatologist once a year to get a skin check and follow up on some moles I had removed. Now the office recommends that I go every three months. What gives? -- F.M.

ANSWER: I'm guessing your dermatologist is keeping a close eye on something he or she doesn't like but isn't quite worried enough to do a biopsy. I don't want to second-guess your dermatologist. When you next go back, ask and find out. If you really dislike going so often -- perhaps because of co-payments, inconvenience or having to take time away from work or family -- tell him or her so that you both can work toward a plan that is easiest for you but still allows the dermatologist to keep you free from skin cancer or other problems.

DEAR DR. ROACH: I am 73 years old. Approximately two years ago, I noticed that my body hair (which was about 70 percent gray) was turning back to my younger hair color of dark brown. Currently, almost all of my body hair is dark brown.

I have also noticed that my head hair is getting darker (but at a slower pace than my body hair). I have been concerned that I might have a health issue that is the causative factor. Can you help? -- D.F.

ANSWER: If you and I could figure out how to reliably reverse graying of hair (a phenomenon called repigmentation), we could become wealthy beyond the dreams of avarice. Sadly, nobody has yet succeeding in doing so. I have found some reports of dietary changes (mostly to a more plant-based diet) seeming to cause this reversal. Various supplements claiming to do this are offered for sale online; however, there is no reliable evidence that they work.

There are case reports of some medications causing repigmentation. None of the medications are ones that I would recommend or consider safe for this use. The best studied probably is acitretin, a vitamin A derivative.

I also found case reports of hair color returning in a localized area after shingles and in one case of melanoma, but these are unlikely to be the cause in you. I would look at any medications you might be taking, and see if any have been associated with repigmentation.

DEAR DR. ROACH: I have a question about high HDL. On my last lab test results, my numbers were: total cholesterol 231, HDL 161, LDL 59, triglycerides 53. Is this 161 too high? If so, what do I do about it? My primary care doctor did not comment. -- M.D.

ANSWER: In general, the higher the HDL, the lower the risk of heart disease. 161 is one of the highest I have ever heard of. I would expect your heart disease risk to be lower than average. It is debated whether it's the HDL itself that causes the lower risk, since medications that just raise HDL have not reduced heart disease risk.

I did read a few years ago of a subgroup of people with high HDL who had an increased risk of heart disease. This group also had a high C-reactive protein level, indicating ongoing inflammation. If you have a family history of heart disease despite a high HDL level, I would talk to your doctor about testing your C-reactive protein.

READERS: The booklet on herpes and genital warts explains these two common infections in detail. Readers can obtain a copy by writing: Dr. Roach -- No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow 4-6 weeks for delivery.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

]]>http://health.heraldtribune.com/2015/02/12/check-doctor-checkup-schedule/feed/0Let's have a lesson in digestionhttp://health.heraldtribune.com/2015/02/11/lets-lesson-digestion/
http://health.heraldtribune.com/2015/02/11/lets-lesson-digestion/#commentsWed, 11 Feb 2015 10:00:16 +0000http://health.wp.htcreative.com/?p=23850Read more »]]>DEAR DR. ROACH:Why doesn't drinking water with meals dilute the digestive acids (saliva, hydrochloric), causing less-efficient digestion (or even "heartburn")? Did nature intend for the acids to do their work in the duodenum and small intestine? If that were the case, wouldn't nature have arranged for the acids to be introduced all along the alimentary canal? A lesson in physiology would be greatly appreciated. -- J.P.R.

ANSWER: Few things make me happier than explaining physiology. First off, stomach acid, which is indeed hydrochloric acid, is intended to work only in the stomach. Saliva isn't an acid; it contains amylase, an enzyme that starts to break down carbohydrates.

There is a muscular "valve" at the top of the stomach, called the gastroesophageal sphincter, to keep the acid from damaging the esophagus. (Unfortunately, it doesn't work perfectly in some people, which is how we get gastroesophageal reflux disease). The beginning of the duodenum, the first part of the small intestine, has a tremendous ability to neutralize the acid.

Drinking water does NOT interfere with digestion (in general, it helps with digestion). The stomach is much more than a holding area for food and acid. The lining of the stomach has strong muscles, which break the food up into small particles, and digestive enzymes to dissolve it. During that process, while the solid food is being broken down, any water you drink in excess of what the stomach needs goes through the pylorus (the "valve" between the stomach and duodenum) to get absorbed. In effect, the stomach regulates the food and water, as long as you have had enough water, so that the acids and digestive enzymes will work properly. Digestive enzymes, by the way, work very well, even at low concentration.

DEAR DR. ROACH: I have been diagnosed with venous leakage. I was wondering, if I decided to get a penile implant, exactly what is involved in the procedure, and can it be done as an outpatient service? I am 69 years old and in fairly good health. -- D.O.

ANSWER: Venous leak is a less-common cause of erectile dysfunction. An erection is achieved when the blood supply to the penis is increased while the outflow is decreased, leading to increased pressure and volume. In venous leak, the outflow cannot be stopped, so the erection is lost. This most commonly happens in men with vascular disease or diabetes. Men with venous leak syndrome are less likely to have success with oral medications that treat ED, such as Viagra. Although there are surgical techniques to try to repair venous leaks, surgery is not commonly done, as success rates are reported at only 30 percent to 50 percent. I suspect the lack of more standard treatments is why you are considering a penile implant.

I can't tell you exactly what is involved, since the surgeon will need to decide what kind of implant is appropriate: semi-rigid, two-piece inflatable or three-piece inflatable. The three-piece inflatable devices are most commonly used now. All the procedures normally are done as outpatient procedures. The major complication is infection, but the rates of infection are very low for highly experienced urologists. Eighty percent to 90 percent of men report satisfaction with the results of the penile implant.

There are many places on the Internet to get more information. I found the patient information at the Mayo Clinic site (www.mayoclinic.org, search "penile implants") to be excellent.

Diabetes can be a contributing factor in venous leak. The booklet on it provides insight on its diagnosis and treatment. Readers can order a copy by writing: Dr. Roach -- No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.